Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 28.687
Filtrar
2.
J Affect Disord ; 277: 977-985, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33065842

RESUMO

BACKGROUND: In February 2020 the first cases of COVID-19 were identified in Kuwait. Inevitably as many countries worldwide, the general public were negatively affected by the pandemic. Unemployment, uncertainty, distress, increasing deaths, lockdown measures all of which are potential burdens on mental health. AIM: To assess the impact of COVID19 outbreak on mental health in Kuwait, and to explore the potential influencing risk factors. METHODS: We conducted an online questionnaire-based study in Kuwait between 25th May 2020 to 30th May 2020. Questions were based on demographics, lifestyle during outbreak, depression and anxiety assessment. Total PHQ9 and GAD7 scores were calculated for each responder. RESULTS: We had 4132 responders. Most were females (69.31%), married (59.37%), between the age of 21-30 (23.84%) and non-smokers (81.46%). Only (7.96%) had a positive past psychiatric history, (32.04%) had a past history of a chronic medical disease. During the outbreak most of the responders lost their jobs (39.21%) and only (12.83%) were attending work regularly, only (6.82%) worked in the healthcare sector. 59.27% report increased social media use compared to before the lockdown. When asked about their daily time spent following COVID19-related news, most (37.8%) spend more than 2 hours and (7.74%) spend more than 4 hours. The overall prevalence of depressive symptoms was (30.13%) and the prevalence of anxiety symptoms was (25.28%). LIMITATIONS: In the cross-sectional nature of the study. CONCLUSION: The COVID-19 pandemic caused a burden on mental health. Psychological support and mental health awareness should be implemented and made accessible to all individuals during pandemics.


Assuntos
Infecções por Coronavirus/psicologia , Efeitos Psicossociais da Doença , Pandemias , Pneumonia Viral/psicologia , Quarentena/psicologia , Adolescente , Adulto , Idoso , Ansiedade/epidemiologia , Ansiedade/psicologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Kuweit/epidemiologia , Estilo de Vida , Masculino , Saúde Mental , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Mídias Sociais , Inquéritos e Questionários , Desemprego , Adulto Jovem
3.
Tohoku J Exp Med ; 252(2): 159-168, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33041315

RESUMO

The double burden of malnutrition is the coexistence of two different conditions, mainly reflected as excess or deficit in weight. Anemia is a specific nutritional deficit not always included in the double burden assessment. We reviewed overweight and/or obesity (OW/OB) and anemia studies from Latin-American Children over the last ten years up to 2019. Two authors evaluated the MEDLINE, SCOPUS, and LILACS databases. A scale of ten questions was used to assess the risk of bias in prevalence studies. Fourteen studies were selected. The population studies' size ranged from 147 to 20,342 children with different socio-economic backgrounds, such as urban, peri-urban and rural settings, socio-economic status, schooling, population (ethnic minorities and indigenous), and environmental differences (sea level or high altitude). The prevalence of OW/OB ranged from 4.9% to 42%. The prevalence of anemia was from 3.4% to 67%. The double burden, including OW/OB and anemia, ranged from 0.7% to 67%. A higher prevalence of excess weight and anemia was found in rural and high altitude above sea level environments, extreme poverty, low education level, and indigenous communities. These heterogeneous data, before the 2020 (COVID-19 pandemic), reflect the vast inequities between countries and within each country. Food insecurity linked to poverty and the induced change in eating habits and lifestyles threaten optimal child nutrition in ongoing and future scenarios. The existence of OW/OB and anemia and their simultaneous coexistence in the community, home, and individual levels, indicates that interventions should be comprehensive to face the double burden of malnutrition.


Assuntos
Anemia/epidemiologia , Efeitos Psicossociais da Doença , Obesidade/epidemiologia , Adolescente , Criança , Pré-Escolar , Geografia , Humanos , Lactente , América Latina , Prevalência , Publicações
5.
Cleve Clin J Med ; 87(10): 619-631, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004323

RESUMO

COVID-19 is primarily considered a respiratory illness, but the kidney may be one of the targets of SARS-CoV-2 infection, since the virus enters cells through the angiotensin-converting enzyme 2 receptor, which is found in abundance in the kidney. Information on kidney involvement in COVID-19 is limited but is evolving rapidly. This article discusses the pathogenesis of acute kidney injury (AKI) in COVID-19, its optimal management, and the impact of COVID-19 on patients with chronic kidney disease, patients with end-stage kidney disease on dialysis, and kidney transplant recipients.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus , Efeitos Psicossociais da Doença , Nefropatias , Pandemias , Administração dos Cuidados ao Paciente/métodos , Pneumonia Viral , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Humanos , Nefropatias/classificação , Nefropatias/epidemiologia , Nefropatias/terapia , Nefropatias/virologia , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia
6.
Mem Inst Oswaldo Cruz ; 115: e200430, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33053052

RESUMO

Despite the medical advances and interventions to improve the quality of life of those in intensive care, people with cancer or severely immunocompromised or other susceptible hosts, invasive fungal diseases (IFD) remain severe and underappreciated causes of illness and death worldwide. Therefore, IFD continue to be a public health threat and a major hindrance to the success of otherwise life-saving treatments and procedures. Globally, hundreds of thousands of people are affected every year with Candida albicans, Aspergillus fumigatus, Cryptococcus neoformans, Pneumocystis jirovecii, endemic dimorphic fungi and Mucormycetes, the most common fungal species causing invasive diseases in humans. These infections result in morbidity and mortality rates that are unacceptable and represent a considerable socioeconomic burden. Raising the general awareness of the significance and impact of IFD in human health, in both the hospital and the community, is hence critical to understand the scale of the problem and to raise interest to help fighting these devastating diseases.


Assuntos
Fungos , Infecções Fúngicas Invasivas/diagnóstico , Efeitos Psicossociais da Doença , Fungos/classificação , Fungos/isolamento & purificação , Humanos , Hospedeiro Imunocomprometido , Unidades de Terapia Intensiva , Infecções Fúngicas Invasivas/complicações , Infecções Fúngicas Invasivas/mortalidade , Qualidade de Vida
7.
West J Emerg Med ; 21(5): 1059-1066, 2020 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-32970555

RESUMO

At the heart of the unparalleled crisis of COVID-19, healthcare workers (HCWs) face several challenges treating patients with COVID-19: reducing the spread of infection; developing suitable short-term strategies; and formulating long-term plans. The psychological burden and overall wellness of HCWs has received heightened awareness in news and research publications. The purpose of this study was to provide a review on current publications measuring the effects of COVID-19 on wellness of healthcare providers to inform interventional strategies. Between April 6-May 17, 2020, we conducted systematic searches using combinations of these keywords and synonyms in conjunction with the controlled vocabulary of the database: "physician," "wellness, "wellbeing," "stress," "burnout," "COVID-19," and "SARS-CoV-2." We excluded articles without original data, research studies regarding the wellness of non-healthcare occupations or the general public exclusively, other outbreaks, or wellness as an epidemic. A total of 37 studies were included in this review. The review of literature revealed consistent reports of stress, anxiety, and depressive symptoms in HCWs as a result of COVID-19. We describe published data on HCW distress and burnout but urge future research on strategies to enhance HCW well-being.


Assuntos
Ansiedade/etiologia , Betacoronavirus , Esgotamento Profissional/etiologia , Infecções por Coronavirus , Depressão/etiologia , Pessoal de Saúde/psicologia , Pandemias , Pneumonia Viral , Transtornos do Sono-Vigília/etiologia , Ansiedade/epidemiologia , Ansiedade/prevenção & controle , Ansiedade/psicologia , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Efeitos Psicossociais da Doença , Depressão/epidemiologia , Depressão/prevenção & controle , Depressão/psicologia , Saúde Global/estatística & dados numéricos , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Fatores de Risco , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/prevenção & controle , Transtornos do Sono-Vigília/psicologia
8.
Am J Perinatol ; 37(12): 1283-1288, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32911555

RESUMO

The novel coronavirus disease 2019 (COVID-19) pandemic is affecting care for high-risk newborns in ways that will likely be sustained beyond the initial pandemic response. These novel challenges present an urgent imperative to understand how COVID-19 impacts parent, family, and infant outcomes. We highlight three areas that warrant targeted attention: (1) inpatient care: visitation policies, developmental care, and communication practices; (2) outpatient care: high-risk infant follow-up and early intervention programs; and (3) parent psychosocial distress: mental health, social support, and financial toxicity. Changes to care delivery in these areas provide an opportunity to identify and implement novel strategies to provide family-centered care during COVID-19 and beyond. KEY POINTS: · The COVID-19 pandemic is influencing care delivery for high-risk newborns and their families.. · Rapid changes to care delivery are likely to be sustained beyond the initial pandemic response.. · We have an urgent imperative to understand how COVID-19 impacts infant, parent, and family outcomes..


Assuntos
Assistência Ambulatorial , Comunicação , Infecções por Coronavirus , Efeitos Psicossociais da Doença , Assistência à Saúde/métodos , Hospitalização , Pandemias , Pais/psicologia , Assistência Perinatal , Pneumonia Viral , Betacoronavirus , Intervenção Educacional Precoce , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Saúde Mental , Política Organizacional , Pediatria , Relações Profissional-Família , Risco , Apoio Social , Telemedicina , Telefone , Comunicação por Videoconferência , Visitas a Pacientes
9.
Rev Gastroenterol Peru ; 40(2): 162-172, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32876633

RESUMO

The pandemic of COVID-19 (an infectious disease caused by the SARS-CoV2 virus), declared as such by the WHO, is spreading since its appearance in Wuhan (China) in December 2019, rapidly and unexpectedly throughout the world, causing millions of cases and thousands of deaths and has affected more than 120 countries. It was officially acknowledged in Peru on March 6th, 2020, and has spread rapidly throughout the country, causing first the crisis and then the collapse of the healthcare system, especially emergency care, admissions, and overcrowded intensive care units, not having a specific treatment or the foreseeable possibility of a short-term vaccine. COVID-19 is currently known for being a systemic disease that can affect multiple organs and tissues and can be fatal. The goal of this review is to present what has been described in recent studies, published worldwide and including our country, that have reported clinical manifestations, outlining possible mechanisms of liver dysfunction related to COVID-19 and its repercussions, especially on the digestive system. These studies analyze and discuss the potential impact on liver diseases, offering recommendations of experts and scientific organizations regarding prevention, control and management measures, outlining also some public health strategies in our country for the proper care of COVID-19 patients in times of widespread crisis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Hepatopatias/virologia , Pneumonia Viral/complicações , Saúde Pública , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Efeitos Psicossociais da Doença , Humanos , Hepatopatias/diagnóstico , Hepatopatias/epidemiologia , Hepatopatias/fisiopatologia , Pandemias , Peru/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia
10.
Medicine (Baltimore) ; 99(35): e21609, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871877

RESUMO

BACKGROUND: Cervical disc replacement (CDR) has been widely used as an effective treatment for cervical degenerative disc diseases in recent years. However, the cost of this procedure is very high and may bring a great economic burden to patients and the health care system. It is reported that outpatient procedures can reduce nearly 30% of the costs associated with hospitalization compared with inpatient procedures. However, the safety profile surrounding outpatient CDR remains poorly resolved. This study aims to evaluate the current evidence on the safety of outpatient CDR METHODS:: Four English databases were searched. The inclusion and exclusion criteria were developed according to the PICOS principle. The titles and abstracts of the records will be screened by 2 authors independently. Records that meet the eligibility criteria will be screened for a second time by reading the full text. An extraction form will be established for data extraction. Risk of bias assessment will be performed by 2 authors independently using Cochrane risk of bias tool or Newcastle-Ottawa scale. Data synthesis will be conducted using Stata software. Heterogeneity among studies will be assessed using I test. The funnel plot, Egger regression test, and Begg rank correlation test will be used to examine the publication bias. RESULTS: The results of this meta-analysis will be published in a peer-review journal. CONCLUSION: This will be the first meta-analysis that compares the safety of outpatient CDR with inpatient CDR. Our study will help surgeons fully understand the complications and safety profile surrounding outpatient CDR. OSF REGISTRATION NUMBER:: doi.org/10.17605/OSF.IO/3597Z.


Assuntos
Procedimentos Cirúrgicos Ambulatórios/estatística & dados numéricos , Vértebras Cervicais/patologia , Degeneração do Disco Intervertebral/cirurgia , Substituição Total de Disco/métodos , Efeitos Psicossociais da Doença , Feminino , Humanos , Pacientes Internados , Masculino , Viés de Publicação , Segurança , Substituição Total de Disco/economia , Resultado do Tratamento
13.
Mol Med Rep ; 22(4): 3035-3048, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32945405

RESUMO

The coronavirus disease­2019 (COVID­19) pandemic, caused by the new coronavirus SARS­CoV­2, has spread around the globe with unprecedented consequences for the health of millions of people. While the pandemic is still in progress, with new incidents being reported every day, the resilience of the global society is constantly being challenged. Under these circumstances, the future seems uncertain. SARS­CoV­2 coronavirus has spread panic among civilians and insecurity at all socio­political and economic levels, dramatically disrupting everyday life, global economy, international travel and trade. The disease has also been linked to the onset of depression in many individuals due to the extreme restriction measures that have been taken for the prevention of the rapid spreading of COVID­19. First, the socio­economic, political and psychological implications of the COVID­19 pandemic were explored. Substantial evidence is provided for the consequences of the pandemic on all aspects of everyday life, while at the same time we unravel the role and the pursuits of national regimes during this unforeseen situation. The second goal of this review is related to the scientific aspect of the pandemic. Hence, we explain why SARS­CoV­2 is not a so­called 'invisible enemy', and also attempt to give insight regarding the origin of the virus, in an effort to reject the conspiracy theories that have arisen during the pandemic. Finally, rational strategies were investigated for successful vaccine development. We are optimistic that this review will complement the knowledge of specialized scientists and inform non­specialized readers on basic scientific questions, and also on the social and economic implications of the COVID­19 pandemic.


Assuntos
Infecções por Coronavirus , Efeitos Psicossociais da Doença , Pandemias , Pneumonia Viral , Infecções por Coronavirus/psicologia , Humanos , Pneumonia Viral/psicologia , Política , Ciência , Classe Social , Fatores Socioeconômicos , Vacinas Virais
14.
PLoS One ; 15(9): e0237931, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32911494

RESUMO

INTRODUCTION: We conducted an implementation science study to increase TB case detection through a combination of interventions at health facility and community levels. We determined the impact of the study in terms of additional cases detected and notification rate and compared the yield of bacteriologically confirmed TB of facility based and community based case finding. METHODOLOGY: Over a period of 18 months, similar case finding activities were conducted at George health facility in Lusaka Zambia and its catchment community, an informal peri-urban settlement. Activities included awareness and demand creation activities, TB screening with digital chest x-ray or symptom screening, sputum evaluation using geneXpert MTB/RIF, TB diagnosis and linkage to treatment. RESULTS: A total of 18,194 individuals were screened of which 9,846 (54.1%) were screened at the facility and 8,348 (45.9%) were screened in the community. The total number of TB cases diagnosed during the intervention period were 1,026, compared to 759 in the pre-intervention period; an additional 267 TB cases were diagnosed. Of the 563 bacteriologically confirmed TB cases diagnosed under the study, 515/563 (91.5%) and 48/563 (8.5%) were identified at the facility and in the community respectively (P<0.0001). The TB notification rate increased from 246 per 100,000 population pre-intervention to 395 per 100,000 population in the last year of the intervention. CONCLUSIONS: Facility active case finding was more effective in detecting TB cases than community active case finding. Strengthening health systems to appropriately identify and evaluate patients for TB needs to be optimised in high burden settings. At a minimum, provider initiated TB symptom screening with completion of the TB screening and diagnostic cascade should be provided at the health facility in high burden settings. Community screening needs to be systematic and targeted at high risk groups and communities with access barriers.


Assuntos
Efeitos Psicossociais da Doença , Instalações de Saúde , Características de Residência , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Adulto , Assistência à Saúde , Feminino , Geografia , Humanos , Masculino , Tuberculose/classificação , Zâmbia/epidemiologia
15.
PLoS One ; 15(9): e0238683, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32936815

RESUMO

We report and interpret preferences of a sample of the Dutch adult population for different strategies to end the so-called 'intelligent lockdown' which their government had put in place in response to the COVID-19 pandemic. Using a discrete choice experiment, we invited participants to make a series of choices between policy scenarios aimed at relaxing the lockdown, which were specified not in terms of their nature (e.g. whether or not to allow schools to re-open) but in terms of their effects along seven dimensions. These included health-related effects, but also impacts on the economy, education, and personal income. From the observed choices, we were able to infer the implicit trade-offs made by the Dutch between these policy effects. For example, we find that the average citizen, in order to avoid one fatality directly or indirectly related to COVID-19, is willing to accept a lasting lag in the educational performance of 18 children, or a lasting (>3 years) and substantial (>15%) reduction in net income of 77 households. We explore heterogeneity across individuals in terms of these trade-offs by means of latent class analysis. Our results suggest that most citizens are willing to trade-off health-related and other effects of the lockdown, implying a consequentialist ethical perspective. Somewhat surprisingly, we find that the elderly, known to be at relatively high risk of being affected by the virus, are relatively reluctant to sacrifice economic pain and educational disadvantages for the younger generation, to avoid fatalities. We also identify a so-called taboo trade-off aversion amongst a substantial share of our sample, being an aversion to accept morally problematic policies that simultaneously imply higher fatality numbers and lower taxes. We explain various ways in which our results can be of value to policy makers in the context of the COVID-19 and future pandemics.


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Política de Saúde , Modelos Econométricos , Pandemias , Pneumonia Viral/psicologia , Quarentena/psicologia , Valor da Vida , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Altruísmo , Comportamento de Escolha , Controle de Doenças Transmissíveis/legislação & jurisprudência , Controle de Doenças Transmissíveis/métodos , Comportamento do Consumidor , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Efeitos Psicossociais da Doença , Pesquisa Empírica , Feminino , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Pandemias/economia , Pandemias/legislação & jurisprudência , Pandemias/prevenção & controle , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Quarentena/economia , Quarentena/legislação & jurisprudência , Quarentena/estatística & dados numéricos , Risco , Instituições Acadêmicas , Valores Sociais , Impostos , Adulto Jovem
16.
PLoS One ; 15(8): e0237865, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32866187

RESUMO

BACKGROUND: Illness-related costs experienced by tuberculosis patients produce a severe economic impact on households, especially poor families. Few studies have investigated the full costs, including direct and indirect costs, at the patient and household levels in south-east China. METHODS: A case follow-up study was conducted in the Bao'an district of Shenzhen City, China. Eligible new and previously treated individuals with pulmonary tuberculosis (TB) during January 1st 2013 to June 30th 2013 were enrolled. Medical and non-medical costs as well as income loss were calculated in diagnosis and treatment periods, respectively. Factors associated with costs due to TB diagnosis, treatment and TB care (diagnosis + treatment) were explored respectively with a linear regression model. RESULTS: Of the total 514 TB patients enrolled, 95% were from the migrant population, and 65% were males, with a mean age of 32.25 (±10.11). The median costs due to TB diagnosis and TB treatment were 79 United States dollar (USD), 748USD (6.2897 China Yuan (CNY) = 1USD, 2013) per patient, respectively. The median costs due to TB care (diagnosis and treatment) per patient was 1218USD, corresponding to 26% of patients' annual income pre-illness. Those who visited more times to health facilities, hospitalized, received higher education, or occupied in national civil servant/services/retired staff might expense more before diagnosis. Costs due to TB treatment was significantly higher among migrant patients, sputum smear positive patients, and widowed/divorced population. Factors associated with less total costs were native patients, fewer times of visiting to health-care facilities and those with no hospitalization history due to TB. CONCLUSIONS: Although a free TB control policy is in force, patients with TB are still facing a heavy economic burden. More available interventions to reduce the financial burden on tuberculosis patients are urgently needed.


Assuntos
Efeitos Psicossociais da Doença , Tuberculose/diagnóstico , Tuberculose/economia , Adulto , China/epidemiologia , Fatores de Confusão Epidemiológicos , Feminino , Custos de Cuidados de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Tuberculose/epidemiologia , Tuberculose/terapia , Adulto Jovem
17.
Lancet Glob Health ; 8(10): e1282-e1294, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32971051

RESUMO

BACKGROUND: Worldwide, smoking tobacco causes 7 million deaths annually, and this toll is expected to increase, especially in low-income and middle-income countries. In Latin America, smoking is a leading risk factor for death and disability, contributes to poverty, and imposes an economic burden on health systems. Despite being one of the most effective measures to reduce smoking, tobacco taxation is underused and cigarettes are more affordable in Latin America than in other regions. Our aim was to estimate the tobacco-attributable burden on mortality, disease incidence, quality of life lost, and medical costs in 12 Latin American countries, and the expected health and economic effects of increasing tobacco taxes. METHODS: In this modelling study, we developed a Markov probabilistic microsimulation economic model of the natural history, medical costs, and quality-of-life losses associated with the most common tobacco-related diseases in 12 countries in Latin America. Data inputs were obtained through a literature review, vital statistics, and hospital databases from each country: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Honduras, Mexico, Paraguay, Peru, and Uruguay. The main outcomes of the model are life-years, quality-adjusted life-years, disease events, hospitalisations, disease incidence, disease cost, and healthy years of life lost. We estimated direct medical costs for each tobacco-related disease included in the model using a common costing methodology for each country. The disease burden was estimated as the difference in disease events, deaths, and associated costs between the results predicted by the model for current smoking prevalence and a hypothetical cohort of people in each country who had never smoked. The model estimates the health and financial effects of a price increase of cigarettes through taxes, in terms of disease and health-care costs averted, and increased tax revenues. FINDINGS: In the 12 Latin American countries analysed, we estimated that smoking is responsible for approximately 345 000 (12%) of the total 2 860 921 adult deaths, 2·21 million disease events, 8·77 million healthy years of life lost, and $26·9 billion in direct medical costs annually. Health-care costs attributable to smoking were estimated to represent 6·9% of the health budgets of these countries, equivalent to 0·6% of their gross domestic product. Tax revenues from cigarette sales cover 36·0% of the estimated health expenditures caused by smoking. We estimated that a 50% increase in cigarette price through taxation would avert more than 300 000 deaths, 1·3 million disease events, gain 9 million healthy life-years, and save $26·7 billion in health-care costs in the next 10 years, with a total economic benefit of $43·7 billion. INTERPRETATION: Smoking represents a substantial health and economic burden in these 12 countries of Latin America. Tobacco tax increases could successfully avert deaths and disability, reduce health-care spending, and increase tax revenues, resulting in large net economic benefits. FUNDING: International Development Research Centre (IDRC), Canada.


Assuntos
Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde/estatística & dados numéricos , Fumar/economia , Fumar/epidemiologia , Impostos/economia , Produtos do Tabaco/economia , Humanos , América Latina/epidemiologia , Cadeias de Markov , Modelos Econômicos , Impostos/estatística & dados numéricos , Produtos do Tabaco/estatística & dados numéricos
18.
Nihon Koshu Eisei Zasshi ; 67(8): 501-508, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32879236

RESUMO

Objectives Medical expenses for diabetes differ between Japan's 47 prefectures. The medical care expenditure regulation plan aims to reduce regional differences in outpatient medical costs through prevention of severe diabetes, promotion of specific health checkups and specific health guidance, promotion of generic drugs, and proper use of medicines. To achieve this goal, we need to conduct an in-depth analysis of inter-prefecture differences in diabetes care expenses. This study analyzed regional differences in prescription fees for dipeptidyl peptidase-4 (DPP-4) inhibitors and the use of generic sulfonylureas (SUs), glinides, biguanides, α-glucosidase inhibitors (α-GIs), and thiazoline derivatives, using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB). Furthermore, we analyzed regional differences in consultancy fees for dialysis prevention.Methods We analyzed the 2nd NDB Open Data Japan website of the Ministry of Health, Labor, and Welfare. Pearson's correlation coefficient (r) was used to evaluate the relationship between the medical costs of diabetes and each factor. The correlation coefficient was analyzed with Student's t-test, and a P-value<0.05 was considered statistically significant.Results Regarding oral hypoglycemic drugs, prefectures with a large number of DPP-4 inhibitors tended to have higher medical costs of diabetes (r=0.40, P=0.0048). Furthermore, such expenses tended to be low in prefectures where the use of generic SU drugs was high (r=-0.43, P=0.0023).Conclusions In conclusion, the results revealed regional differences in the use of DPP-4 inhibitors and generic SU drugs, which may contribute to the regional differences in medical expenses for diabetes. This study suggests that NDB open data are useful for policy making to reduce regional differences in outpatient medical costs of diabetes.


Assuntos
Serviços de Saúde Comunitária/economia , Efeitos Psicossociais da Doença , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/economia , Inibidores Enzimáticos/administração & dosagem , Inibidores Enzimáticos/economia , Custos de Cuidados de Saúde , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/economia , Compostos de Sulfonilureia/administração & dosagem , Compostos de Sulfonilureia/economia , Análise de Dados , Diabetes Mellitus/prevenção & controle , Dipeptidil Peptidase 4 , Humanos , Japão , Honorários por Prescrição de Medicamentos , Encaminhamento e Consulta/economia
19.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32764151

RESUMO

BACKGROUND AND OBJECTIVES: The outbreak of coronavirus disease 2019 has changed American society in ways that are difficult to capture in a timely manner. With this study, we take advantage of daily survey data collected before and after the crisis started to investigate the hypothesis that the crisis has worsened parents' and children's psychological well-being. We also examine the extent of crisis-related hardships and evaluate the hypothesis that the accumulation of hardships will be associated with parent and child psychological well-being. METHODS: Daily survey data were collected between February 20 and April 27, 2020, from hourly service workers with a young child (aged 2-7) in a large US city (N = 8222 person-days from 645 individuals). A subsample completed a one-time survey about the effects of the crisis fielded between March 23 and April 26 (subsample n = 561). RESULTS: Ordered probit models revealed that the frequency of parent-reported daily negative mood increased significantly since the start of the crisis. Many families have experienced hardships during the crisis, including job loss, income loss, caregiving burden, and illness. Both parents' and children's well-being in the postcrisis period was strongly associated with the number of crisis-related hardships that the family experienced. CONCLUSIONS: Consistent with our hypotheses, in families that have experienced multiple hardships related to the coronavirus disease 2019 crisis, both parents' and children's mental health is worse. As the crisis continues to unfold, pediatricians should screen for mental health, with particular attention to children whose families are especially vulnerable to economic and disease aspects of the crisis.


Assuntos
Saúde da Criança , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Saúde Mental , Pandemias , Relações Pais-Filho , Pais/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Afeto , Betacoronavirus , Criança , Cuidado da Criança/psicologia , Pré-Escolar , Efeitos Psicossociais da Doença , Inquéritos Epidemiológicos , Humanos , Renda , Desemprego/psicologia , Populações Vulneráveis/psicologia
20.
PLoS One ; 15(8): e0237677, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817648

RESUMO

BACKGROUND: The present study investigated the factor structure of positive aspects of caregiving (PAC) scale among primary informal caregivers providing care to persons with dementia (PWD) in Singapore. METHODS: 282 primary informal caregivers of PWD were recruited from the Institute of Mental Health, and Changi General Hospital and administered the 9-item PAC scale. A confirmatory factor analyses (CFA) was conducted to test the model fit of the 9-item PAC proposed by the scale developer and multiple linear regression was used to investigate the significant socio-demographic correlates. RESULTS: CFA showed that the 2-factor structure including 'Self-Affirmation' and 'Outlook on Life' had an acceptable model fit. After controlling for confounding variables, Malay caregivers were associated with higher scores on PAC and 'Self-Affirmation' compared to caregivers of other ethnicities. Caregivers with Secondary or below education level had higher PAC and 'Outlook on Life' scores. Caregivers who had received formal training scored higher in PAC, 'Self-Affirmation' and 'Outlook on Life'. DISCUSSION: The present study confirmed that the 2-factor structure of the 9-item PAC was suitable for informal caregivers of PWD in Singapore. The findings have important implications for locally available interventions to enhance caregiver's psychological well-being and reduce burden of care.


Assuntos
Adaptação Psicológica , Cuidadores/psicologia , Demência/epidemiologia , Psicometria , Adulto , Idoso , Idoso de 80 Anos ou mais , Efeitos Psicossociais da Doença , Demência/psicologia , Feminino , Humanos , Modelos Lineares , Masculino , Saúde Mental , Pessoa de Meia-Idade , Análise Multivariada , Qualidade de Vida , Singapura , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA